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Before diving down to that, let's touch upon on what's driving the growing chorus for such counseling platforms. Apart from the obvious figures quoted by World Health Organisation last year - around 94 million Indians suffers from some or the other mental issues such as depression of various types and anxiety disorders - there is a lack of accessible treatment. That's because first, hospitals are not interested in investing time and resources in the space as there is no in-patient revenue for them.

"A hospital thrives on the revenue from operation theatre but for mental health treatment there is hardly any surgery involved," says Davesh Manocha who launched Juno Clinic - online clinic for mental wellness along with Arun Kumar and Anuraag Srivastava. Second, almost 80 per cent of India's top psychologists and psychiatrists are scattered across top five-six cities. This means no basic access to mental health therapists beyond these cities and hence, online treatment is the only alternative. Third, as families are getting nuclear, talking to the family members is getting improbable today. "Mental health issues could be taken care of by talking to someone in a joint family set up but now there is only so much that can be done," says Dr Amit Malik, Founder and Chief Executive Officer, InnerHour and a trained psychiatrist since over a decade.

Value Game

So the demand for psychological wellness is taking shape. But is there value creation in such platforms and if yes, how that could be apparent to patients? That's the first big problem since historically it has been significantly affiliated to social disgrace and conventionally the patient has been stamped as psychopath with abnormal or violent social behavior. Consequently, there has also been an issue of privacy as the patient or his/her family members or friends don't want the problem to be disclosed to their social circle. But that attitude is fast changing with increased social acceptance.

"As the stigma attached is disappearing, mental health is now getting productized. So there are programs for depression, de-addiction, stress, anxiety etc.," says Dr Vijay Raaghavan, Associate Director, Healthcare, PricewaterhouseCoopers India. Hence, instead of going to a therapist or a counselor offline, where there is a standard process to de-stress, separate programs allow patients and counselors for problem-specific sessions. Moreover, since the sessions are online-first, which includes chat and phone-based (audio and video) support, it solves the problem for lack of privacy.

For instance, counseling for de-addiction of drugs wherein the patient fears of being labeled as an addict socially, the online channel with better privacy control mitigates that issue. "This further reduces the overall cost for the program, even as it helps counselors deliver better value to the patient," adds Raaghavan. It usually costs upwards of INR 1,000 for a session of 50-75 minutes offline versus INR 400 and above on the online platforms. For example, YourDost, another similar platform charges INR 1,000 per week for five-week program on marital relationship, whereas a regular relationship counselor charges over INR 1,500 per session. But much like in any healthcare business, the most important factor for success for these start-ups too is the clinical efficacy.

Since the delivery of treatment is taking place digitally, hence the workflow right from recording patient details, diagnosing the problem, counseling, and medication if required has to be seamless. This means that element of collaboration has to be deeply engrained in the process since there are multiple people involved in a single case - counselor or therapist, psychiatrist prescribing medication, psychologist doing the assessment etc. "Telemedicine in healthcare is just a delivery layer to connect the doctor and the patient but the business has to be built around telemedicine," adds Manocha. For example, at Juno Clinic, the patients can begin with choosing the therapist and the time slot, pay for the session and start with the counseling. At the backend, the patient details are synced with the psychiatrist and psychologist for medication and further